Intraocular lens insertion system

ABSTRACT

A surgical device for implantation of deformable intraocular lens into the eye through a relatively small incision made in the ocular tissue including a holder with receiver for a lens holder. A lens holder for a surgical device for implantation of deformable intraocular lens into the eye including a split tubular member having a fixed tubular portion and a moveable tubular portion: connected together at a hinge. A method for implantation of deformable intraocular lens into the eye using the above-described surgical devices.

This application is a continuation of U.S. patent application Ser. No.08/368,197, filed Jan. 4, 1995, now U.S. Pat. No. 5,582,614, which is acontinuation of U.S. patent application Ser. No. 08/221,013, filed Apr.1, 1994, Now U.S. Pat. No. 5,494,484, which is a continuation of U.S.patent application Ser. No. 07/953,251, filed on Sep. 30, 1992, nowabandoned.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to a system including methods and devices for thesurgical implantation of deformable intraocular lenses into the eye.

2. Prior Art

Intraocular lenses have gained wide acceptance in replacement of humancrystalline lenses after a variety of cataract removal procedures. Thehuman crystalline lens is generally recognized to be a transparentstructure having a thickness of about five (5) millimeters and adiameter of about nine (9) millimeters. The lens is suspended behind theiris by zonula fibers which connect the lens to the ciliary body. A lenscapsule surrounds the lens, the front portion of the capsule beingcommonly known as the anterior capsule and the back portion commonlyknown as the posterior capsule.

Numerous procedures for the removal of cataracts have been developed inwhich the lens is removed from the eye and replaced by an artificiallens implant. The extraction procedure may generally be categorized asintracapsular (in which the lens is removed together with the lenscapsule) and extracapsular (in which the anterior capsule is removedwith the lens, and the posterior capsule is left intact).

Since Ridley implanted the first artificial lens in about 1949, theproblems associated with cataract extraction and lens implantation havereceived a great deal of attention from ophthalmic surgeons. Varioustypes of artificial lenses have been proposed, and appropriate surgicalprocedures have been developed which strive to reduce patient discomfortand to reduce postoperative complications. Reference is made in thisconnection to Pseudophakos by N. Jaffe et al.; "History of IntraocularImplants" by D. P. Choyce (Annals of Ophthalmology, October 1973); U.S.Pat. No. 4,251,887 issued to Anis on Feb. 24, 1981; U.S. Pat. No.4,092,743 issued to Kelman on Nov. 8, 1977; "Comparison of FlexiblePosterior Chamber Implants", presented at the American IntraocularImplant Society Symposium Apr. 23, 1982, by Charles Berkert, M.D.; and"the Simcoe Posterior Lens" (Cilco, Inc. 1980); U.S. Pat. No. 4,573,998issued to Mazzocco on Mar. 4, 1986, and U.S. patent application Ser. No.400,665 for "Improved Fixation System for Intraocular Lens Structures",filed Jul. 22, 1982, U.S. Pat. No. 4,702,244 issued to Mazzocco on Oct.27, 1987; and U.S. Pat. No. 4,715,373 issued to mazzocco et al. on Dec.29, 1987, which disclosures are hereby incorporated by reference.

Of particular interest in the context of the present invention is thedevelopment of surgical techniques requiring relatively small incisionsin the ocular tissue for the removal of cataracts as disclosed in U.S.Pat. No. 4,002,169 and U.S. Pat. No. 3,996,935. A number of skilledartisans have disclosed intraocular lens structures comprising anoptical zone portion generally made of rigid materials such as glass orplastics suitable for optical use.

However, one of the principal disadvantages of the conventional rigidintraocular lens is that implantation of the lens requires largeincisions in the ocular tissue. This type of surgical procedure leads toa relatively high complication rate, among other disadvantages. Forinstance, the serious dangers associated with implantation of a rigidlens structure include increased risk of infection, retinal detachment,and laceration of the ocular tissue, particularly with respect to thepupil.

Accordingly, those skilled in the art have recognized a significant needfor surgical tools for implantation of deformable intraocular lensstructures which afford the clinical advantages of using relativelysmall incision techniques, which provide a safer and more convenientsurgical procedure. In particular, those skilled in the art ofdeformable intraocular lenses and methods and devices for implantation,;have also recognized a significant need for surgical tools which do notrequire widening of the wound made in the ocular tissue during or afterimplantation, but will deform the intraocular lens to a predeterminedcross section in a stressed state and which allow the ophthalmic surgeonto inspect the lens prior to implantation without manipulation in theeye. The present invention fulfills these needs.

The present invention was derived by improving the methods and devicesin the above-identified patents, specifically the methods of U.S. Pat.No. 4,573,998 and the devices of U.S. Pat. No. 4,702,244.

SUMMARY OF THE INVENTION

An object of the present invention is to provide an improved systemincluding methods and devices for surgical implantation of deformableintraocular lenses.

Another object of the present invention is to provide a surgical deviceincluding a lens holder, which can be loaded with a deformableintraocular lens, and then inserted into a holder having means forimplanting the lens.

A further object of the present invention is to provide a surgicaldevice including a lens holder define by a microcartridge comprising alens holding portion in combination with a nozzle for implanting thelens.

A still further object of the present invention is to provide a lensholding microcartridge for receiving a lens comprising a split tubularmember having a fixed portion with an extension, and a moveable portionwith an extension for opening and closing the microcartridge, whichextensions prevent rotation between the microcartridge and holder wheninstalled in the holder.

An even further object of the present invention is to provide a lensholding microcartridge having a nozzle provided with slots for rotatingthe lens as it exits the nozzle.

An object of the present invention is to provide a surgical deviceincluding a lens holder and a holder for the lens holder, the holdercomprising a receiver for the lens holder and a plunger for insertingthe lens.

Another object of the present invention is to provide a holder definedby a cylindrical tubular member with an opening through the wall of thetubular member defining a receiver for the lens holder, and a plungerhaving a tip for contacting with and moving a lens contained in the lensholder.

A further object of the present invention is to provide a plunger with afaceted tip that provides clearance for a trailing haptic in apassageway through the lens holder during the implantation process toprevent damage to the trailing haptic.

An even further object of the present invention is to provide a plungerhaving a tip with a concave conical surface at the tip thereof forgrabbing the lens during the implantation process.

An object of the present invention is to provide improved methods ofimplanting deformable intraocular lenses;

Another object of the present invention is to provide a method includingloading a deformable intraocular lens into a lens holder having animplantation nozzle, condensing the intraocular lens within the lensholder, and implanting the lens into the eye.

The present invention concerns a system including methods and devicesfor implantation of intraocular lenses into the eye.

The surgical device according to the present invention includes thecombination of a lens holder and a holder for the lens holder. Thepreferred lens holder comprises the combination of a lens receiver andan implantation nozzle.

The lens receiver is preferably defined by a microcartridge comprising asplit tubular member having a fixed tubular portion with an extensionconnected to a moveable tubular portion with an extension at a hinge.This configuration allows the microcartridge to be opened to accept adeformable intraocular lens, and closed to condense the lens into thepassageway. The split tubular portion is connected to a nozzle with acontinuous passageway passing through the tubular member and the nozzle.

The lens holder is inserted into a holder having means for driving ormanipulating the lens from the lens holder into the eye. In thepreferred embodiment, the holder is provided with a plunger for drivingthe lens from the lens holder into the eye. Further, the holder isconfigured to receive a microcartridge having a nozzle.

The preferred holder includes means to prevent the microcartridge fromrotating within the holder, and means for preventing the plunger fromrotating within the holder. The means for preventing rotation of themicrocartridge within the holder can be define by providing themicrocartridge with one or more extensions that cooperate with theopening of the receiver of the holder to prevent rotation. The means forpreventing the plunger from rotating within the holder can be defined byproviding the plunger and a sleeve within the holder with a particularcross-sectional shape that prevents rotation, for example, a half-circleshape.

The preferred holder includes a plunger with a threaded cap cooperatingwith a threaded sleeve of the holder body for dialing the plungerforward within the holder for precise and accurate movement of the lensduring the implantation process. The holder is configured so that theplunger can be moved a predetermined distance by sliding motion withinthe holder body followed by engagement of the threaded cap of theplunger with the threaded sleeve of the holder body to continue theforward progress of the plunger tip.

The preferred plunger tip is defined by a faceted tip having varioussurfaces for moving and manipulating the lens from the lens holder andwithin the eye. The tip is designed to provide a clearance lens hapticreceiving relief between the tip and the inner surface of the passagewaythrough lens holder to accommodate the trailing haptic and preventdamage thereto. Once the lens is inserted into the eye, the tip can beused to push and rotated the lens into proper position within the eye.

A method according to the present invention includes lubricating thesurface of a deformable intraocular lens with a surgically compatiblelubricant, and loading the lens into a microcartridge in the openedposition. The microcartridge is closed while condensing the lens by afolding action into a shape so that it can be forced through thepassageway in the microcartridge. The microcartridge is inserted intothe holder with the plunger retracted.

The plunger is moved forward in a sliding manner by pushing the plungerforward while holding the holder body still. This action forces the lensfrom the tubular member portion of the microcartridge into the nozzleportion. At this point the threads of the threaded end cap of theplunger engage with the threads of the threaded sleeve. The threaded endcap is rotate slightly to engage the threads. The device is now readyfor the implantation process.

The nozzle of the microcartridge is placed through a small incision inthe eye. The threaded end cap of the plunger is rotated or dialed tofurther advance the lens forward through the nozzle and into the eye.The threaded end cap is further dialed to exposed the tip of the plungerwithin the eye and push the lens into position. The tip can be used toalso rotate the lens within the eye for positioning of the haptics.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of one embodiment of device according tothe present invention with a lens holding microcartridge positioned inthe device for implantation of deformable lens structures for placementin the eye;

FIG. 2 is a perspective view of the surgical device depicted in FIG. 1with the plunger retracted, and with the lens holding microcartridgeremoved;

FIG. 3 is a side view of the device depicted in FIG. 2, with the plungerin the extended position;

FIG. 4 is a side elevational view of the device shown in FIG. 1;

FIG. 5 is a detailed longitudinal cross-sectional view of the deviceshown in FIG. 4;

FIG. 6 is a detailed transverse cross-sectional view of the device, asindicated in FIG. 5;

FIG. 7 is a detailed end view of the device, as indicated in FIG. 5;

FIG. 8 is an enlarged detailed left side elevational view of the tip ofthe plunger in the spacial orientation as shown in FIG. 1;

FIG. 9 is an enlarged detailed end view of the tip shown in FIG. 8;

FIG. 10 is an enlarged detailed top planar view of the tip of theplunger;

FIG. 11 is an enlarged detailed right side elevational view of the tipof the plunger in the spacial orientation, as shown in FIG. 4;

FIG. 12 is an enlarged detailed bottom view of the tip of the plunger inthe spacial orientation, as shown in FIG. 1;

FIG. 13 is a perspective view of a lens for use in the presentinvention;

FIG. 14 is a perspective view of another type of lens for use in thepresent invention;

FIG. 15 is a side view of the lens shown in FIG. 13;

FIG. 16 is a perspective view of the lens holding microcartridge in theopen position to allow a lens to be loaded therein;

FIG. 16A is another perspective view of the lens holding microcartridgein the open position;

FIG. 17 is a rear end elevational view of the lens holdingmicrocartridge in the open position;

FIG. 18 is a front end elevational view of the lens holdingmicrocartridge in the open position;

FIG. 19 is a rear end elevational view of the lens holdingmicrocartridge in the closed position;

FIG. 20 is a front end elevational view of the lens holdingmicrocartridge in the closed position;

FIG. 20A is a detailed end view of the nozzle showing three (3) slots ofdifferent length equally spaced about the circumference of the tip;

FIG. 20B is a detailed perspective view of the tip showing the three (3)slots of different length;

FIG. 21 is a top planar view of the lens holding microcartridge in theopen position;

FIG. 22 is a side elevational view of the lens holding microcartridge inthe closed position;

FIG. 23 is a rear end elevational view of the lens holdingmicrocartridge in the closed position;

FIG. 24 is a broken away side view of the device showing the lensholding microcartridge in relationship to the plunger in the retractedposition;

FIG. 25 is a broken away side view of the device showing the lensholding microcartridge in relationship to the plunger in a partiallyextended position;

FIG. 26 is a broken away side view of the device showing the lensholding microcartridge in relationship to the plunger in a fullyextended position;

FIG. 27 is a perspective view showing the device positioning adeformable intraocular lens within the eye;

FIG. 28 is a cross-sectional view of an eye showing the positioning ofthe deformable intraocular lens into position in the eye by the surgicaldevice;

FIG. 29 is a cross-sectional view of an eye showing the positioning ofthe deformable intraocular lens into a different position in the eye bythe surgical device.

FIG. 30 is a side elevational view of an alternative embodiment of thelens holding microcartridge provided with a beveled tip;

FIG. 31 is a rear end elevational view of another alternative embodimentof the lens holding microcartridge provided with grooves in thepassageway to facilitate folding the cartridge in an open position;

FIG. 32 is a rear end elevational view of another alternative embodimentof the lens holding microcartridge provided with grooves in thepassageway to facilitate folding the cartridge in a closed position;

FIG. 33A is a front end elevational view of the nozzle of an alternativeembodiment of the lens holding microcartridge; and

FIG. 33B is a front end elevational view of the nozzle of a furtheralternative embodiment of the lens holding microcartridge.

DESCRIPTION OF PREFERRED EMBODIMENTS

The present invention is directed to a system including methods anddevices for implantation of deformable intraocular lens structures forsurgical placement in the eye.

An inventive device according to the present invention comprises aholder having a receiver, a lens holder that can be removably insertedinto the receiver of the holder, and means such as a moveable plungerdisposed within the holder to force and manipulate the lens from thelens holder into the eye.

Preferably, the lens holder is defined by a lens holding microcartridgefor receiving the lens structure. Further, the microcartridge ispreferably a structure configured to be opened and closed. The preferredembodiment of the microcartridge receives a lens having prescribedmemory characteristics when in the open position, and performs thefunction of folding or deforming the lens structure into a condensedconfiguration when being closed. Alternatively, the microcartridge canbe a structure having a passageway defined by a continuous walledannulus, and a lens could be inserted into the passageway from the endof microcartridge by compressing, rolling, folding, or combination ofthese techniques prior to insertion into the microcartridge.

Once a lens is positioned into the microcartridge, the microcartridge ispositioned into a plunger device. The assembled device maintains thelens in its condensed configuration during insertion into the eye yetpermits the deformed lens to return to its original configuration, sizeand fixed focal length once implanted in the eye, thereby providing asafe, convenient, and comfortable surgical procedure.

A preferred embodiment of a deformable intraocular lens implantationdevice 10 according to the present invention is shown in FIGS. 1, 2 and3. The implantation device comprises a microcartridge 12 disposed withina holder 13 comprising a holder body 14 with a receiver 15, and amoveable plunger 16. In FIG. 1, the receiver 15 is defined by an opening17 through the wall of the holder body 14 of the size and shape shown inFIGS. 1 and 2. The opening 17 is defined by parallel edges 17a, 17a,which are sufficiently spaced apart to allow the microcartridge 12 to beloaded into the receiver 15 of the holder 13, tapered edges 17b,clamping edges 17c, and stop edge 17d. In FIG. 1, the microcartridge 12is positioned in the receiver 15 between the clamping edges 17c with theplunger extending through the microcartridge 12 in a position, forexample, after a lens implantation procedure.

In FIG. 2, the lens holding microcartridge 12 is shown removed from theholder 13 with the plunger 16 in a retracted position for allowing themicrocartridge 12 containing a loaded lens and its haptic to be insertedwithin the holder 13. In FIG. 3, the holder 13 is shown with the plunger16 in the extended position without the microcartridge 12 for purposesof illustration of the components.

The plunger 16 is fitted with a threaded end cap 18 at one end, andfitted with a tip 20 at an opposite end. The threaded end cap 18 isprovided with a plurality of grooves 22 to a allow a person to tightlygrip the cap 18 with his or her finger tips. The threaded end cap 18 isreceived within a threaded sleeve 24 of the insert holder 14. Thethreaded end cap 18 can be a separate component attached to the insertholder 13, or integral therewith, as shown in the construction is FIG.5.

The plunger 16 is installed within the holder 13 in a manner to allowthe plunger to be reciprocated therein. In the illustrated embodiment,the plunger 16 is supported for sliding movement within the holder 13 byguide 26, as shown in FIGS. 5 and 6. The outer dimension of the guide 26is approximately the same size as the inner dimensions of the holder 13to allow the guide to be inserted within the insert holder. Duringconstruction, the guide 26 is inserted within the holder 13, and lockedinto position by pin 28 inserted into a predrilled hole in both the wallof the holder 13 and guide 26.

The cross-sectional shape of the plunger 16 as well as the shape of theinner surface of the guide 26 are approximately a half-circle, as shownin FIG. 6. This arrangement prevents the plunger 16 from rotating withinthe holder 13 to maintain the orientation of the tip 20 relative to theholder 13 during operation.

The threaded end cap 18 is connected to the plunger 16 in a manner toallow the threaded end cap 18 to be rotated relative to the plunger 16.For example, the left end of the plunger 16 (FIG. 5) is provided with athreaded extension 30, which is secured to the threaded end cap 18 by anut 32. Specifically, the threaded end cap 18 is manufactured withexternal threads 34 and a longitudinal center bore 36 that ends on theright side of the threaded end cap 18 leaving a wall 38.

The wall 38 is provided with a hole slightly larger than the outerdiameter of the threaded extension 34 to allow the threaded end cap 18to freely rotate on the plunger 16 while being secured to the end of theplunger 16. During construction, the nut 32 is inserted through thecenter bore 36 and threaded onto the extension 30 to secure the threadedend cap 18 to the plunger 16. A curved cap 40 is press fitted into theend of the center bore 36 to seal the center bore 36 to prevent debrisfrom entering therein during use.

The details of the tip arrangement are shown in FIGS. 7 to 12. Theplunger 16 is manufactured with an extension 42 supporting tip 20. Thetip 20 structure provides means for inserting the deformable intraocularlens into the eye and manipulating the lens within the eye after theinsertion step. For example, the tip 20 is faceted in the manner shownin the figures. Specifically, the left side of the tip 20 shown in FIG.8 is provided with a flat surface facet 48, conical surface 44, andcylindrical surface 46. The right side shown in FIG. 11 is provided witha concave surface facet 50.

The end face of the tip 20 is designed to push the lens into positiononce inserted into the eye. For example, the end face is defined by aconcave cylindrical surface 52 shown in FIG. 8.

Suitable deformable intraocular lens for use in the present inventionare shown in FIGS. 13-15. The deformable intraocular lens 54 shown inFIGS. 13 and 15 includes a lens body 56 with attachment means defined bya pair of haptics 58 each having one end anchored in the lens portion 56and a free end for attachment to the eye tissue. The deformableintraocular lens 60 shown in FIG. 14 includes a lens body 62 andattachment means defined by a pair of lateral lobes 64 of the lensportion 62.

The details of the preferred lens holding microcartridge 12 are shown inFIGS. 16-20. The microcartridge 12 comprises a split tubular member 66extending to a continuous tubular member 67 and an implantation nozzle68. When the microcartridge is in a closed position, a continuouscircular or oval passageway of the same diameter (or, if oval, of thesame major axis) extends through the split tubular member 66 through thecontinuous tubular member 67 and through the implantation nozzle 68. Themicrocartridge is preferably made of injection molded plastic such aspolypropylene The split tubular member 66 is defined by a fixed portion70 and a moveable portion 72. The fixed portion 70 is fixed relative tothe implantation nozzle 68, and is defined by a tubular portion 74 andextension 76. The moveable portion 72 is moveable relative to the fixedportion 70 for opening and closing the split tubular member 66. Themoveable portion 72 is defined by a tubular portion 78 and extension 80.A hinge 82 is provided between the fixed portion 70 and moveable portion72. The hinge 82 is defined by reducing the thickness of the walls ofthe tubular portion 74 and 78 at the hinge 82, as shown in FIGS. 17, 18and 19. The hinge 82 runs the length of the split tubular member 66 toallow the extension 76 and 80 to be split apart, or brought together toopen and close, respectively, the split tubular member 66.

The tubular portion 78 of the moveable portion 72 is provided with asealing edge 84, which is exposed when the lens holding microcartridge12 is opened, as shown in FIG. 16A, and seals with a similar sealingedge 86 (See FIGS. 17 and 21) of the continuous tubular member 67 whenthe lens holding microcartridge is closed.

The end of the tip 69 is provided with three (3) equally spaced slots87a, 87b and 87c of different length provided about the circumferencethereof, as shown in FIGS. 20A and 20B. The slot 87a positioned at thetop of the tip 69 is the shortest, slot 87c on the right side of the tip69 is the longest, and slot 87b on the left side is of medium length.The slots 87a, 87b, 87c, cause the lens 54 to rotate as it exits the tip69.

Other embodiments of the microcartridge 12 according to the presentinvention are shown in FIGS. 30-33.

The microcartridge shown in FIG. 30 is provided with a beveled tip 94 tofacilitate entry of the tip through the incision in the eye duringimplantation. The beveled tip 94 can be set at approximately forty-five(45) degrees relative to the passageway through the microcartridge 12.

The embodiment of the microcartridge shown in FIGS. 31 and 32 isprovided with a set of grooves 96 provided inside the passagewaytherethrough from the inlet end to the outlet end. The groovesaccommodate the edges of the lens being loaded into the microcartridgeto facilitate bending of the lens. Specifically, the edges of the lensare placed in the grooves 96 to prevent relative slippage of the edgeswith the inner surface of the passageway through the microcartridge whenthe microcartridge is being folded into the closed position.

The embodiments of the microcartridge shown in FIGS. 33A and 33B eachhave a nozzle 68 having an oval cross-section with slots 87' differentlyposition as shown, respectively, again to facilitate entry through anincision in the eye. Alternatively, the cross-section can be two halfcircles set apart and connected together rather than oval.

The various features of the microcartridges shown in FIGS. 16-21 and30-33 can be used in various combinations to achieved an optimum designfor a particular application. However, all of these features aretypically considered improvements of the basic combination.

The components of the device 10, except for the microcartridge 12, arepreferably fabricated from autoclavable material such as stainless steelor from a disposable rigid plastic such as medical grade ABS or thelike.

METHODS OF IMPLANTATION

The surgical procedure begins by coating the lens with a surgicallycompatible lubricant, and loading the lens into the microcartridge. Forexample, as shown in FIG. 21, a lens 54 having a lens body 56, a leadinghaptic 58a is load into the microcartridge 12 while a trailing haptic58b remains trailing outside the microcartridge in the manner shown.Specifically, the lens 54 is loaded downwardly into the openedmicrocartridge 12 until it sits on the inner surfaces (lens receivingchamber) of the tubular portions 74 and 78, for example, with a pair oftweezers. The outer circumferential surface of the lens 54 are held byedges 88 and 90 of the tubular portions 74 and 78, respectively. Therear edge of the lens 54 is placed approximately at the rear edge inletend of the microcartridge 12. The lens 54 is further manipulated tosituate the haptics 58a and 58b in the manner shown. Specifically,haptic 54a is positioned in a leading position and the other haptic 54bis positioned in a trailing position outside with respect to thedirection of implantation, as indicated by the arrow.

Subsequently, the split tubular member 66 of the microcartridge 12 isclosed about the lens 54 by forcing the extensions 76 and 80 togetherwith his or her finger tips. The inner surfaces of the tubular portions74 and 78 bend and fold the lens 54 when the extensions 76 and 80 areforced together, as shown in FIGS. 22 and 23. Due to the resilientnature of the deformable intraocular lens 54, the lens 54 conform to thecurved inner surface of the tubular portions 74 and 78 without damagethereto, as shown in FIG. 23.

The microcartridge 12 containing the loaded lens 54 is inserted betweenthe edges 17a, 17a of the opening 17 into the receiver 15 of the holder13. As the microcartridge 12 is moved forward, the extensions 76 and 80move past the tapered edges 17b and come to a stop position between theclamping edges 17c when front portions of the extensions 76 and 80contact with the stop edge 17d. The clamping edges 17c prevent rotationof the microcartridge inside the holder 13.

The user pushes the threaded end cap 18 forward while securing theholder body 14 from movement, forcing the plunger 16 forward within theholder. As the plunger 16 is moved forward, the tip 20 enters into therear inlet end of the microcartridge 12 and misses the trailing haptic58B until the tip makes contact with the loaded lens 54, as shown inFIG. 24. As the plunger 16 is moved forward in this manner, the lens 54previously lubricated, is forced into the implantation nozzle 68 of themicrocartridge 12, as shown in FIG. 25.

Once the lens 54 enters the implantation nozzle 68, the threads of theend cap 18 contact with the threads of the sleeve 24 stopping furthermovement of the plunger 14 forward in this manner. The end cap 18 isslightly rotated to engage the threads of the end cap 18 with thethreads of the sleeve 24. At this point, the surgical device is readyfor the implantation step. The nozzle is insert through the incision inthe eye, and the end cap 18 is rotated to continue the forward movementof the plunger 16 by continued rotation of the end cap 18 relative tothe holder body 14 to expel the lens from the nozzle into the interiorof the eye, as shown in FIG. 26. This manner of screw advancement formoving the plunger 16 forward provides for precise control and accuracyconcerning forcing the lens 54 through the remaining portion of thenozzle 68 into the eye during the implantation procedure. The deformedlens after exiting the nozzle 68 returns to its original configuration,full size and fixed focal length.

After the lens is inserted into the eye, the end cap 18 is furtherrotated to fully expose the tip 20 of the plunger 16, as shown in FIGS.28 and 29, to allow the lens to be pushed forward, side manipulated torotate the lens, and pushed down to properly position the lens withinthe eye without the aid of other surgical instruments.

The configuration of the tip 20 is important during the implantationprocess. The faceted tip 20 provides a clearance between the tip 20 andthe inner surface of the passageway through the microcartridge 12 toaccommodate the trailing haptic 58b during movement of the lens withinthe microcartridge 12, as shown in FIGS. 25 and 26. Specifically, thereexists a sufficient clearance between the flat surface facet 44 and theinner wall of the passageway through the microcartridge 12. During theimplantation process, the trailing haptic floats around in the space(lens haptic receiving relief) between the extension 42 of the tip 20and the inner wall of the passageway, as shown in FIG. 25. This preventsany chance of damage to the trailing haptic, for example, by beingcaught between the tip 20 and the lens 54 during the implantationprocess. The leading haptic moves through the passageway unimpededduring the implantation process preventing any damage thereto.

I claim:
 1. A surgical apparatus for implantation of a deformableintraocular lens into an eye, said apparatus comprising:a generallytubular body provided with a longitudinal disposed lens passagewayhaving a lens inlet end and an outlet end for insertion into an eye,said lens inlet end and outlet end connected by a pair of mutuallyopposing longitudinal lens engaging grooves for guiding opposing edgeportions of said lens as said lens is advanced through said passagewayfrom said inlet end to said outlet end; and means for advancing saidlens through said passageway from said inlet end through said outletend.
 2. The apparatus of claim 1 wherein said inlet end is an elongatedtransverse aperture having a major axis and wherein proximal ends ofsaid lens engaging grooves are disposed relative to said major axis toslidingly engage diametrically opposed peripheral edge portions of saidlens, said opposing longitudinal grooves extending from said inlet endtowards said outlet end to a position above said major axis.
 3. Theapparatus of claim 1 wherein said outlet end is a generally circulartransverse aperture.
 4. The apparatus of claim 1 wherein said inlet endand said outlet end are coaxially aligned along a longitudinal axis ofsaid passageway.
 5. The apparatus of claim 4 wherein said means foradvancing is a coaxially aligned plunger longitudinally disposed withinsaid tubular body and provided with a lens engaging tip.
 6. Theapparatus of claim 5 wherein said lens engaging tip is provided with alens haptic receiving relief.
 7. The apparatus of claim 1 furthercomprising a tip disposed in coaxial lens conducting communication withsaid outlet end.
 8. The apparatus of claim 1 wherein said tubular bodyis provided with a lens receiving chamber disposed adjacent to saidinlet end.
 9. An apparatus for inserting a flexible intraocular lensinto an eye, said apparatus comprising:a generally tubular body providedwith a longitudinally disposed passageway having a longitudinal axis, aninlet end and a generally circular outlet end longitudinally alignedwith said inlet end, said passageway having a pair of mutually opposedlens engaging grooves dimensioned to engage and guide peripheral edgesof said lens; a lens receiving chamber disposed adjacent to said inletend; a plunger longitudinally disposed within said tubular body andaligned coaxially with the longitudinal axis of said passageway; and atip coaxially aligned with said passageway at said passageway outlet.10. The apparatus of claim 9, wherein said plunger is provided with alens-engaging tip having a lens haptic receiving relief.
 11. Theapparatus of claim 9, wherein said tip is detachably mounted to saidlens-engaging passageway adjacent to said outlet end.
 12. A method forinserting a flexible intraocular lens into an eye, said methodcomprising the steps of:loading an uncurled lens into an apparatushaving a passageway internally configured with grooves for guidingopposing peripheral edges of said lens from a passageway inlet to apassageway outlet to form a curled reduced lens shape capable of passingthrough a minimal incision in the eye; inserting said passageway outletinto said incision; and advancing said lens through the passageway ofthe apparatus and out of the passageway outlet into the eye.
 13. Themethod of claim 12, wherein said loading step includes introducing saidlens into a receiving chamber adjacent to said passageway.
 14. Themethod of claim 13 wherein said advancing step includes displacing aplunger longitudinally along the interior of the apparatus from saidreceiving chamber through said passageway.
 15. The method of claim 14wherein said advancing step includes displacing said plunger through aextension of said outlet end.
 16. The method of claim 12 wherein saidinserting step comprises inserting a tip extension of said outlet endinto said incision.